中国实用妇科与产科杂志

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妇科恶性肿瘤盆腔淋巴清扫后淋巴囊肿处理

王延洲梁志清   

  1. 作者单位:第三军医大学西南医院妇产科,重庆 400038
  • 出版日期:2016-11-02 发布日期:2016-11-09
  • 通讯作者: 梁志清

Management of lymphocele formation after lymphadenectomy for gynecological malignancies.

WANG Yan-zhouLIANG Zhi-qing.   

  1. Department of Obstetrics & Gynecology,Southwest Hospital,Third Military Medical University,Chongqing 400038,China
  • Online:2016-11-02 Published:2016-11-09

摘要:

淋巴囊肿是妇科恶性肿瘤盆腔淋巴清扫术后常见的并发症。为了预防淋巴囊肿形成可采用开放盆腔腹膜、大网膜成型术、使用奥曲肽等方法,但是,术后放置盆腔引流管并不会降低淋巴囊肿发生率。如果淋巴囊肿压迫周围脏器,影响患者生活质量或者发生感染,则需要治疗。超声或CT引导下经皮穿刺引流可能是一种简单有效的治疗方法,有时还会加用无水乙醇或碘伏等硬化剂治疗。腹腔镜手术在淋巴囊肿治疗中也显示了较好的应用前景。但是,具体手术方式应结合临床情况、治疗经过和手术医生的经验综合分析、个体化治疗。

关键词: 妇科恶性肿瘤, 盆腔淋巴清扫术, 淋巴囊肿

Abstract:

Abstract:Postoperative lymphocele formation is a common complication of lymphadenectomy for gynecological malignancies.Several techniques are possible to decrease the incidence of lymphocele when used in combination,such as:leaving the peritoneum open at the end of the surgical procedure,omentoplasty,postoperative octreotide therapy.However,routine postoperative drainage had no detectable benefits in most of the recent prospective studies.If the lymphocele cause pressure symptoms related to their size or location,affect the quality of life of patients or become infected,the lymphocele should be treated.Ultrasound or CT-guided percutaneous catheter drainage may be a simple and efficient method of treatment,sometimes added with sclerotization agents of Ethanol and betadine.Laparoscopic surgery also showed a good prospect in the treatment of lymphatic cyst.But the choosing of surgical approach should be combined with specific clinical circumstances and experience of the surgeon.Comprehensive analysis of individualized treatment should be considered before the surgery.

Key words: gynecological malignancies, pelvic lymphadenectomy, lymphocele

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